Abstract
Maternal diet plays a critical role in epigenetic changes and the establishment of the gut microbiome in the fetus, which has been associated with weight outcomes in offspring. This study examined the association between maternal diet quality before pregnancy and childhood body mass index (BMI) in offspring. There were 1936 mothers with 3391 children included from the Australian Longitudinal Study on Women’s Health (ALSWH) and the Mothers and their Children’s Health (MatCH) study. Maternal dietary intakes were assessed using a semi-quantitative and validated 101-item food-frequency questionnaire (FFQ). The healthy eating index (HEI-2015) score was used to explore preconception diet quality. Childhood BMI was categorized as underweight, normal, overweight, and obese based on sex and age-specific BMI classifications for children. Multinomial logistic regression with cluster-robust standard errors was used for analyses. Greater adherence to maternal diet quality before pregnancy was associated with a lower risk of offspring being underweight after adjustment for potential confounders, highest vs. lowest quartile (relative risk ratio (RRR) = 0.68, 95% confidence interval (CI): 0.49, 0.96). Higher adherence to preconception diet quality was also inversely linked with the risk of childhood obesity (RRR = 0.49, 95% CI: 0.24, 0.98). This association was, however, no longer significant after adjusting for pre-pregnancy BMI. Sodium intake was significantly associated with decreased risk of childhood overweight and obesity (RRR = 0.18, 95% CI: 0.14, 0.23) and (RRR = 0.21, 95% CI: 0.17, 0.26), respectively. No significant association was detected between preconception diet quality and offspring being overweight. This study suggests that better adherence to maternal diet quality before pregnancy is associated with a reduced risk of childhood underweight and obesity.
Highlights
Childhood underweight, overweight, and obesity are increasingly rife, which have a substantial impact on adulthood health and quality of life
Childhood underweight is a serious public health concern, especially in low and middle-income countries, which has been linked with a greater risk of infectious diseases and leads to overweight and obesity in adulthood [7,8]
We found that higher adherence to maternal diet quality before pregnancy was associated with a reduced risk of offspring being obese and underweight
Summary
Overweight, and obesity are increasingly rife, which have a substantial impact on adulthood health and quality of life. Over 340 million children and adolescents aged 5–19 are overweight/obese [1]. In 2018, ∼8% of Australian children aged 5–14 were obese and 12% had overweight [2]. Overweight, and obesity are linked with adverse health outcomes throughout the life-span [3]. Overweight/obese children are more likely to become obese adults [4] and have a greater risk of metabolic, pulmonary, and cardiovascular diseases, including diabetes, hypertension, stroke, and asthma. Childhood underweight is a serious public health concern, especially in low and middle-income countries, which has been linked with a greater risk of infectious diseases and leads to overweight and obesity in adulthood [7,8]
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